Women's Health Equals Women's Wealth

Josie Cox didn't set out to write about the relationship between women's economic power & American healthcare. But after she finished WOMEN MONEY POWER, the link between the two seemed inextricable.

Josie Cox, author of WOMEN MONEY POWER: The Rise and Fall of Economic Equality

Last weekend, I read a headline about my net worth that was so untrue, it was both laughable and infuriating. I took a screenshot before asking The Daily Mail, a British Tabloid¹, to change it under their own rules of The Independent Press Standards Organisation (IPSO), whose first edicts are as follows:

1. The Press must take care not to publish inaccurate, misleading or distorted information or images, including headlines not supported by the text.

2. A significant inaccuracy, misleading statement or distortion must be corrected, promptly and with due prominence, and – where appropriate – an apology published.

Anyway, here’s the screenshot:

Their journalist—it seems strange to call someone a journalist who artlessly regurgitated my partner’s Modern Love from last weekend and stole our personal photos off the internet—figured out my home address, did a Zillow search of the property, and decided, based on no evidence, that I owned the building and was therefore a millionaire. Spoiler alert: I am neither an owner nor a millionaire. I am a renter who rents the upper two floors of a building from my landlords and still lives hand-to-mouth at the age of 57. I’m not proud of this: it just is.

Had this journalist done even a modicum of journalism, he would have learned that I’d recently published a memoir in which I describe how being a female divorcée at the mercy of both the American healthcare system and American style capitalism had bankrupted me. But the saddest part for me, reading that headline, wasn’t even how laughable it was. It was this: if there were any justice in this world—if writing, caretaking, and making art were valued in our society as much as moving money from here to there; if healthcare in this country were a human right instead of a privilege; if I hadn’t spent so many years being sexually harassed in the workplace and paid much less than my male counterparts, like the time I learned my male coworker was earning $200,000 a year to my $38,000—I would be a millionaire.

Business reporter Josie Cox decided to write her book WOMEN MONEY POWER after one of the most powerful men in America stated, on a Zoom call with many others, that the pay gap between men and women continues to exist not because of systemic discrimination, bias, a long history of being celebrated (Rosie the Riveter!) then shunned (go back to the suburbs, Rosie), or a constant eroding of our reproductive freedoms but because, well, women, he said, are just not as ambitious as men.

Josie interviewing Anna Mae Krier who, like Rosie the Riveter, went to work for Boeing during the war until she was told, when the men came home, that she was no longer needed.

I tore through the book and insisted Josie speak to me before I left on vacation today. Which meant she had to take time out of her Saturday to do so. Herewith is our conversation, which I’ve taken the liberty of condensing and clarifying below. But Josie is just so winning and articulate when she speaks in her perfect British clip, I would urge you all to listen to her. And then figure out what the hell we can all do to fix this problem. Hint: codifying frozen IVF embryos into living humans ain’t it. Especially since our actual living humans, once born, are not provided with any of the basic human rights (healthcare, affordable childcare, paid maternity leave for the mother, etc.) so many other countries take for granted.

Deborah Copaken: You’re a business reporter. You've seen it all. You've been in all of these places where there are lots of white men in suits, and you decide to write Women, Money, and Power. Why?

Josie Cox: I've been a business reporter for about fifteen years now, and I feel like every twist and every turn, it's white and it's male, so I feel like I've been writing it ever since I started reporting on this topic. That being said, during the height of the pandemic, I had the opportunity to interview probably one of the most powerful men in America.

Who?

I can't tell you. I wish I could. It was an off the record conversation. I asked him why he thinks the gender pay gap still exists. He said, first of all, what I need to understand is that his organization never pays women and men different amounts of money for doing the same work. He's essentially quoting the Civil Rights Act from 1964 back at me, which I was surprised that he even thought was necessary but there you go. And then he said to me is that the other thing I have to understand is that sometimes when a heterosexual couple decides to have a baby, and a woman temporarily takes a maternity leave to give birth, when she comes back into the paid labor market, she's sometimes not as professionally ambitious as her male counterpart.

I almost threw this book across the room when I read that. I was so upset.

Yeah. And I was too. I was stunned. And I was actually so stunned that, unlike me, I couldn't even muster a follow-up question because everything that had to be said was said, and I knew so much from the response about who this person was and how he runs his company. Anyway, for me, that was the trigger point. I came off that Zoom call, and I knew I had to start writing this book. The question that guided me throughout the whole thing was, "Why, despite the fact that we have been fighting for equality for hundreds of years, that we've had all this immense legislative change in the last fifty years, why do we still have this gaping gender pay gap? Why has it barely moved in 20 years? And why is motherhood still such an inflection point for so many women particularly as they embark on their career trajectory?"

And what did you say to this man? Did you just swallow it and say [to yourself], "Okay, I'm going to go do the research right now"?

Yeah, I did. I did. Everything I needed to know about the culture that he oversaw, that he encouraged at his company, was summed up in the response that he gave me. Of course, there's an element of truth to what he said. I'm not denying it entirely. I went freelance when I had my daughter because the circumstances meant that that was the smartest decision for our particular family in that situation. But the fact that that was the first thing he cast for, that his instinct was to essentially place the onus on women's choice and not on something that was more systemic or the infrastructure that was not available to women. Anything else would've been better. But essentially, he just pointed the finger and said, "Well, the gender pay gap is simply because women aren't as ambitious as men."

In the middle of the book, you talk about the six men who are heading these big banks and they're being grilled by a Black Congress member or senator? And they all sat there, with their mouths agape, without saying or raising their hand when he asked the question, "Can you see your bank being led by a minority or a woman?" And nobody volunteered their hand.

It was a select committee hearing, and I think it was the 10th anniversary of the financial crisis. So it was in 2019, and it was Congressman Al Green who was questioning the CEOs of all of Wall Street's biggest investment banks. So Goldman Sachs, Morgan Stanley, JP Morgan, Citi, et cetera. And ostensibly the hearing was to establish whether these particular individuals had learned from their mistakes and learned how to prevent systemic risks from seeping into the system. The conversation also turned to the homogeneity at the top of America's investment banks. Al Green asked this really important question. He noted that the men before him all seem to be white and all seem to be male, which they asserted was the case. They actually all have the same accent except one as well.

The Australian, right?

The Australian. And [Green] said, "I would ask you to raise your hand if you consider it likely that you will be replaced by a woman or a person of color." And no one raised their hand. And again, you have to caveat these things because the succession plans at investment banks, particularly when it comes to the CEO are matters that are shrouded in secrecy. They move stock markets. So of course no one wants to give any clue as to who might replace them, especially if there's only one woman or one person of color in the running. That would spark some rumors. But nonetheless, the optics screamed. Screamed!

Another point in the book really got me thinking, and it was a moment where Michelle Obama happened to mention Lean In, which was a huge success at the time that it came out. But I remember reading it [at the time] and thinking, "Where's the childcare part of this in here? Where's the maternity leave part of this in here? This is all fine and well, if you have lots and lots of money, but you can't lean in if the system is not set up for you to do so."

Yeah, exactly.

What did Michelle Obama say? Do you remember?

She said, "That shit doesn't work." I think those were her exact words. And I commend her for speaking truth, because I actually have to say when I first read Lean In, I felt emboldened. I was like, "Yeah, you go, girl." I was in my early 20s. I hadn't had kids yet. I was at the beginning of my career. I was all ready to be ambitious and fight-y, and then it sunk in. Then I had a kid, then I had to choose between job and being a mom because of my particular circumstances. And I should say we had a good combined household income, and yet I still had to make that choice. And I just think that the Lean In narrative actually has so much to do with that story we were just discussing about the CEO saying that it's women's choice. Once again, the Lean In narrative, coming from a very different direction, in the same way places the onus on women to fix themselves in order to fix the problem, which is so systemic, and, A) is impossible, and B) is unfair, right?

Right. And let's talk about how that “leans into,” so to speak, healthcare for women. Talk a little bit about how Women, Money, and Power and health intersect.

It's funny. I knew that when I set out to write this book, that there would be an element of health that I would have to include. There was no way around it. What I didn't anticipate was that the topic of healthcare is so intrinsic to pretty much every single chapter in the book, because they are so inextricably linked. The second chapter in the book is about the 1950s, which were, to my mind, very much characterized by this very quiet fight and project to develop a reproductive healthcare, to develop the contraceptive pill. And I spend the entire chapter writing about how the first oral contraceptive pill was approved by the FDA and who the characters were behind it, who I often say they were written out of history. That's inaccurate. They were never written into history in the first place, right?

Oh, there were so many names in this book that I have never heard of before, and they had crucial roles.

Anyway, but the conclusion that I drew from reporting that chapter was that the approval of the first oral contraceptive pill was unequivocally the most important development in terms of female economic empowerment of the 20th century. When that pill came out in the United States, that meant giving [women] the choice of when they wanted to start a family, whether they wanted to spend time carving out a space for themselves in the paid labor market before they even thought about having kids. It created this distinction between sex and reproduction, and it was liberating. We forget about that, and I think particularly at this time when this godawful war is being waged on reproductive rights in this country.

Right. And the reason that they're [going after IVF] that is they're going after birth control. It was always about going after birth control! It's about women's economic empowerment. That's what it is. They want to turn the tide back to the 1950s, back when we didn't have reproductive freedom. They know-- I'm saying “they” are white males in the Republican Party and white females in the Republican Party-- they know that taking away the pill takes away our [economic] power.

Yes, absolutely. And that's the strange cycle of my research for this book and the writing process. I was writing about 1960 and the approval of the FDA and this obscure woman, Katharine Dexter McCormick--who has become a personal hero--who really dedicated her entire life to funding all of the research and development into the contraceptive pill. So this story of hope and progress and braveness and ambition and freedom and independence. And then towards the end of my writing process when I was about to turn in the manuscript, Roe is overturned, and it was almost too much for my brain to process. We all knew it was coming at that stage, but it was just, I just couldn't believe that in this day and age, considering all of these women who fought for and dedicated their entire existence to this cause.

As somebody who grew up in Switzerland and has a British accent and a British husband, does this make you want to run and hightail it back to London?

It's not going to change anything. And I do continue to believe that the United States sets the pace for other places, good and bad. And I think that it almost feels cliched to say this, but as somebody who is in a position to write books like this and who is in a position to produce journalism on this topic, it always feels like a duty to face it and to be here. And especially the Roe decision, the Dobbs decision back in 2022, I felt so glad that I was here and that I was experiencing what was going on in this country because I knew that it would have repercussions everywhere.

I know we're veering a bit off the topic of your book for a second, but having grown up in Switzerland and lived in London, tell me a little bit about the difference between their healthcare system and our healthcare system.

Oh my goodness. The NHS is fabulous. It's stupendous compared to what's available here. I lived in London for about 10 years. I grew up in Switzerland to a mom who was from Czechoslovakia, a father who was originally British, very multicultural family. We grew up way out in the countryside, studied in the UK, briefly worked in Germany, and then spent 10 years in the UK. And just as an example, I had a problematic pregnancy. I had no amniotic fluid. I had a breach baby. I had a C-section. It was complicated. I didn't pay a cent.

Right. And I paid $9,000 per baby, not covered by insurance back in '95 and '97. And I don’t remember what my 2006 baby cost. It was more than that. It's probably $10,000 at that point. All right. What I really want to ask you about is the women in your book whose names I’ve never heard. I just feel like if we start talking about these women, we will write them into history.

Yes, okay. So I have to first come back to the woman who I just mentioned a minute ago. Her name is Katharine Dexter McCormick. When she died, very few obituaries were written about her but those that were written about her might have mentioned that she was one of the first women to graduate from MIT in 1904. There's so much more to her story than that, but that in itself should be reason enough for us to know her. She's from the Midwest. She grew up in Chicago. She married into a very wealthy Chicago family, the McCormicks. She married Stanley McCormick who was heir to a harvesting equipment empire that is still known today. And pretty soon after they got married, he developed very severe schizophrenia. And Katharine became obsessed with this idea of what would have happened if she had had his baby and if she had passed this disease down to the next generation.

And so as a result of that, she became obsessed with this idea of birth control. She then crossed paths with Margaret Sanger, who of course many of us do know as a highly problematic early pioneer of birth control, but also a champion of eugenics, and this has to be acknowledged loud and clear. Nonetheless, Katharine and Sanger did a lot of work together. And in 1947, Stanley, Katharine's husband, died and she actually inherited about $15 million from him, which at that time made her one of the wealthiest women in the US. Again, no one's ever heard of her, right?

$15 million back then or $15 million in current money?

$15 million back then, which I haven't done the inflation calculation, but that's ton of money. She ended up using that money to single-handedly fund all the research and development that went into making the oral contraceptive pill possible and to get it approved in 1960. Now, it is a very complicated story. The ethics of the trials for that pill were unthinkably horrendous at times. And a lot of the people who worked on the development of that pill had pretty horrible motives for doing so, Margaret Sanger included. But Katharine truly wanted to develop this pill in order to give women freedom over their own lives and independence. And I have absolutely no doubt that she is one of the most important women in our collective fight for economic empowerment.

Never heard her name, ever.

Right. Now, you have.

There was one woman that you talked about, her last name was Born, and she was screaming from the rooftops about credit default swaps and the derivatives market and how they were going to destroy the economy. And then lo and behold, guess what? It destroyed the economy. I love Christine Lagarde's comment that if it had been Lehman Sisters instead of Lehman Brothers, maybe this wouldn't have happened.

Brooksley Born was amazing. She was the head of a pretty obscure agency, a government agency called the CFTC, which is the Commodities Futures Trading Commission, which is the nerdy agency. But she was beyond brilliant. She was highly intellectual, very academic. She was a lawyer. She'd been a partner at her law firm at a time when women just weren't really partners at law firms. And she saw the risks that would eventually lead to the financial crisis. And she talked to Larry Summers about them. She talked to Alan Greenspan about them, and they basically said, "Quiet down, sweetheart. Yeah, don't worry your pretty head about this." And as we all know, it didn't turn out the way that Alan Greenspan and Larry Summers thought it was going to. It turned out exactly as Brooksley Born predicted it would.

Another remarkable woman is Pauli Murray. She was a civil rights activist. She was born in 1910, and she was one of the first people to really talk about the intersection of race and gender in a legal context and in a social context. She was the first Black woman to earn a law degree from Yale Law School. And she also co-founded the National Organization of Women, which is often credited to Betty Friedan, but she actually did it with Betty Friedan. And I was researching the National Organization for Women in the context of the women's movement in the context of Betty Friedan, The Feminine Mystique, all of that. And when I was reading the articles of incorporation for NOW, I saw Pauli Murray's name, and I thought, "Who is this Pauli Murray?"

And she was amazing. There's actually a book about influential women in America, and the author says that when we reflect on the 20th century, all roads will lead to Pauli Murray. And I think that's absolutely right. She collaborated with the late Supreme Court Judge Ruth Bader Ginsburg. She was friends with Eleanor Roosevelt. She was just unequivocally one of the most important characters in both the civil rights movement and the women's movement. And last thing I'm going to say about her is that there's a portrait of her that was recently unveiled at the Yale Club in New York. And now I am not a member of the Yale Club. It might surprise you. I did not go to Yale, but I recently got the opportunity to go into the lobby because I really wanted to see this portrait for myself. And I took a picture of it and I put the portrait on social media, and lo and behold, Pauli Murray's niece got in touch with me.

No way.

Yeah. And so yesterday, actually, I spent two hours on a video call with Pauli Murray's niece. Rosita is her name. She's 82. And she told me all about Aunt Pauli and how Aunt Pauli had taken her to Hyde Park to hang out with Eleanor Roosevelt.

Wow.

And I can't understand why her legacy is not everywhere in New York City and in North Carolina where she also lived and beyond.

A lot of these stories are untold. And when we start telling those stories, I think that is an important first step. But the end of the book, you actually end with some hope. Tell us a little bit about your hopefulness. Because I actually, I am not very hopeful right now, and I want to have a little bit of your optimism rub off on me.

Okay. I like the fact that you mentioned that because this is like a behind the scenes book writing story, but I initially submitted my manuscript without that last chapter. And when we were editing the manuscript, the feedback that I got was, "Is there anything? Is there anything out there?"

Oh my God.

Yeah. And it was a really difficult decision for me because, like you, I feel deeply pessimistic about the times we live in. This assault on reproductive rights, this marginalization of women, a mainstream culture that still objectifies women, undermines them, questions their credibility…

Pays them less.

Right? But it's everything. And I often talk about this gender authority gap whereby women's credibility is questioned readily. So hope is not something that comes easily, but I actually, so what I do in that chapter is that I pinpoint all the things where progress, however small, is present. And one of the examples I talk about, I spent some time with this lady, her name is Ashley All, and she is a campaigner in Kansas. And in August 2022, just a few months after the Dobbs decision, Kansas had a vote on whether to enshrine the right to getting an abortion in the Kansas Constitution.

Now, for anyone who doesn't know, Kansas is a deeply Republican state. At the time of that vote, registered Republicans actually outnumbered registered Democrats two to one. And it was also a stronghold of the anti-abortion movement, the Summer of Mercy. There were some horrible, horrible stories about attacks on abortion rights activists. And yet, despite all this, and thanks to Ashley All's brilliance and strategic genius, the vote passed and abortion has now been enshrined in the Kansas Constitution.

Now, I never wanted this chapter to say if Kansas can do it, anywhere can do it. That's not the point. But the point is that what Ashley and her colleagues did was have conversations with individuals that were rooted in common values and common respects and empathy, and she managed through those conversations to get people to understand that reproductive rights are human rights, that fundamentally that they are healthcare, and just that it's in the economic interest of a state and a country to allow women to have control of their own bodies, right?

Yes. Again, I'm not hopeful, but I will try to remain hopeful in the midst of what we are going through right now.

To be fair, I do call the chapter Hope or something like it. There's a caveat there.

1. You may recognize the newspaper’s name from Prince Harry and Elton John’s suit against them for egregious invasion of privacy. The other plaintiffs are Doreen Lawrence, mother of murdered Black teenager Stephen Lawrence, and David Furnish, Elton John’s husband.